CLINICAL RESEARCH

Physical Activity for Osteoarthritis Management: A Randomized Controlled Clinical Trial Evaluating Hydrotherapy or Tai Chi Classes

MARLENE FRANSEN,1 LILLIAS NAIRN,1 JULIE WINSTANLEY,2 PAUL LAM,3 AND JOHN EDMONDS,4

THE STUDY
Our study of 150 people with arthritis practicing Tai Chi for Arthritis and using hydro-therapy was published in the April issue of Arthritis Care and Research. The concept for this research study was started when Dr. Lam created the Tai Chi for Arthritis pro-gram. It took more than 6 years to find the funding, complete the study, and then publish the results.

Objective. To determine whether Tai Chi or hydrotherapy classes for individuals with chronic symptomatic hip or knee osteoarthritis (OA) result in measurable clinical bene-fits.

Methods. A randomized controlled trial was conducted among 152 older persons with chronic symptomatic hip or knee OA. Participants were randomly allocated for 12 weeks to hydrotherapy classes (n 55), Tai Chi classes (n 56), or a waiting list control group (n 41).

Outcomes were assessed 12 and 24 weeks after randomization and included pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (Medical Outcomes Study Short Form 12 Health Survey [SF-12], version 2), psychological well-being, and physical performance (Up and Go test, 50-foot walk time, timed stair climb).

RESULTS
At 12 weeks, compared with controls, participants allocated to hydrotherapy classes demonstrated mean improvements (95% confidence interval) of 6.5 (0.4, 12.7) and 10.5 (3.6, 14.5) for pain and physical function scores (range 0 100), respectively, whereas participants allocated to Tai Chi classes demonstrated improvements of 5.2 (9.7 (2.8, 16.7), respectively.

Both class allocations achieved significant improvements in the SF-12 physical compo-nent summary score, but only allocation to hydrotherapy achieved significant improve-ments in the physical performance measures. All significant improvements were sus-tained at 24 weeks. In this almost exclusively white sample, class attendance was higher for hydrotherapy, with 81% attending at least half of the available 24 classes, compared with 61% for Tai Chi.

Conclusion: Access to either hydrotherapy or Tai Chi classes can provide large and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA.

KEY WORDS. Osteoarthritis; Hydrotherapy; Tai Chi; Exercise. Arthritis & Rheumatism (Arthritis Care & Research) Vol. 57, No. 3, April 15, 2007, pp 407 14 DOI 10.1002/art.22621 2007, American College of Rheumatology